NURSING

Nursing: PICO(T) Questions and An Evidence-Based Approach

The importance of the PICOT question cannot be underestimated since it is a standard mechanism to determine the specific terms that form a question, for which answers are obtained through evidence-based research. The search strategy has to be systematic to gain effective results, and the results would be transformed into positive patient outcomes afterward. This paper examines a certain PICOT question and the pertinent evidence for applying an evidence-based model to improve the outcomes.

PICOT Elements and Question

Patient/population/problem (P): Adult hospitalized patients

Intervention (I): Low nurse-patient ratio

Comparison (C): High nurse-patient ratios

Outcomes (O): Patient outcomes and satisfaction scores

Time frame (T): Not relevant

Hence the PICO(T) question becomes:

Among adult hospitalized patients, what is the impact of a low nurse-patient ratio compared to a high nurse-patient ratio for impacting patient outcomes and satisfaction scores?

Evidence to Support the PICOT Question

Nurse-patient ratio leads to improved or deteriorated patient conditions, which could be attributed to nurse-sensitive outcomes (NSOs) (Kuoatly et al., 2018). With a nurse shortage, it is witnessed that NSOs are adverse, especially in terms of higher mortality rates, low rescue attempts, infections, and re-hospitalization rates. Latest research suggested that with a low nurse-patient ratio that came out from low nurse staffing, it was evident that a high ratio of falls and hospital-acquired infections (HAIs) along with catheter-associated urinary tract infections (CAUTI) were observed (Kuoatly et al., 2018).

Rationing nursing care (RONC) is valuable in delegating accurate tasks to certain nurses and particular skills administered by specially assigned nurses only...

If patients cannot get medications and obtain the outcomes of nursing tasks, which could be due to nurse burnout as staffing is low, the patients would suffer in terms of satisfaction. Studies had indicated that bloodstream infections were reported at higher rates when the qualified nurse was unavailable. For example, the task had to be fulfilled by the one that might be under training or not specialized in injecting drips (Zhu et al., 2019). The gap in patient outcomes results from a shortage of nurse care, which could be the consequence of failure or...…RAFAELA classification system in which nurses address patient care needs daily because of suitable nurse allocation and shrewd decision-making of hospital resources (Fagerstrom et al., 2018). The systems measures enabled the hospital to measure precisely the nurse workload (NWL) so that favorable working conditions are identified for meeting patients needs (Fagerstrom et al., 2018). The daily need assessment, need fulfillment, and registration of new nurses are recorded in the classification system to measure sensitivity levels for optimal nurse staffing. The study revealed net benefits to be higher with this strategy concerning safety occurrences and mortality rates (Fagerstrom et al., 2018).

Conclusion

The above evidence proves that the nurse-patient ratio needs to be ascertained unerringly so that adverse patient outcomes are prevented to a maximum extent. The triggers of nurse staffing shortage should be accurately determined to realize the intensity beforehand. The shortage could also lead to nurse work overload or burnout that needs to be handled by the higher authority of the hospital management before the patient starts complaining or serious consequences become obvious.

References

Fagerstrom, L., Kinnunen, M.…